Healthcare Provider Details

I. General information

NPI: 1205044195
Provider Name (Legal Business Name): LARA KATHRYN WEEKS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LARA KATHRYN BUCHE

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SOUTHFIELD DR STE 1220
PLAINFIELD IN
46168-4499
US

IV. Provider business mailing address

1100 SOUTHFIELD DR STE 1370
PLAINFIELD IN
46168-4300
US

V. Phone/Fax

Practice location:
  • Phone: 317-838-3443
  • Fax:
Mailing address:
  • Phone: 317-837-5566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01066853A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01066853A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier000000618966
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerANTHEM
# 2
Identifier200954280
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer
# 3
Identifier000001024783
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerINTERNAL MED ANTHEM PIN UNDER TIN 35-2030653
# 4
Identifier000001037742
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerPEDIATRIC ANTHEM PIN UNDER TIN 35-2030653

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: